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The part of the brain most affected by Huntington’s disease, the basal ganglia, are groups of nerve cells (neurons) at the base of the brain. Basal ganglia are responsible for the motor movements of the muscles in the body. When cells in basal ganglia die, a common pathological symptom of HD, a person experiences uncontrollable muscular movements similar to that of fidgetiness. Another disease that produces similar uncontrollable movements symptom is the Parkinson’s disease due to the disease’s effects on a specific area of the basal ganglia called the substantia nigra.

A new app for intelligent glasses, such as Google Glass, might make it possible to improve the gait of patients suffering from Parkinson’s disease. Although there is currently no direct study on the use of Google Glass on HD patients, there have been some studies that use the technology to help patients with Parkinson’s disease. Researchers at the University of Twente’s MIRA Institute have received a grant from the NutsOhra fund for the development of an app that seeks to aid Parkinson’s disease patients. The similarity between the motor symptoms of Parkinson’s and Huntington’s disease means that this application could also be used to help HD patients. Therefore, applications of Google Glass on Parkinson’s disease based on the current research will be used to explore how such technology could help with certain conditions that HD present.

For example, disturbed movement is a primary symptom seen in HD patients. This sometimes presents itself as a shuffling movement with the patient taking small steps, or it may result in the patient constantly looking for additional support. This particular gait also increases the risk of a fall. Researchers have established that this gait can be improved when patients regularly see or hear a pattern. Examples might include stripes on the floor, or the regular ticking of a metronome that time the patients’ gait to the movement. By learning the pattern presented, patients learn to associate certain movement with the risk of falling and other movements with safe direction.

The researchers worked under the leadership of Prof. Richard van Wezel, who is professor of Neurophysiology at the UT and is also affiliated with the Donders Institute in Nijmegen. They are now looking at exploring the possibility of using Google Glass, a high tech pair of glasses which is now coming onto the consumer market and includes a video camera, unobtrusive but clearly visible video screen, speaker, microphone, touchpad, and motion sensor.

Noting the advantage that Google Glass presents, the researchers deem that Google Glass will be also able to provide patients with the regular visual or audible patterns required to help with gait correction. These patterns may take the form of moving stripes or shapes, which the patient sees through the glasses, flashing shapes, or music with varying tempos. The latest intelligent glasses already have inbuilt cameras and accelerometers. By using these, it will be possible to adapt the experience to the individual patient and determine which approach works best.

Currently, the MIRA Institute for Biomedical Technology and Technical Medicine is working on this Google Glass project together with the Donders Institute for Brain, Cognition and Behaviour (Nijmegen), the Medisch Spectrum Twente hospital and the VUmc University Medical Centre in Amsterdam.

The Newcastle University in the UK is also conducting research on how Google Glass can be used to assist sufferers of Parkinson’s disease. The team is working directly with patients to develop straightforward technology that will help patients cope with the disease and become more independent. In this study, the researchers worked with volunteers aging from 46 to 70 to tailor the functionality of the application they hope will best suit the patients’ needs. The most basic application involves medication and appointment reminders.

“Although people would say that you can do all these things on a smartphone, the motor difficulty Parkinson’s disease pose to its patients make it really difficult for the patients to navigate the touch screen,” said Lynn Tearse, a volunteered patient on the study. The ability to place calls and perform other actions using voice commands make Glass a useful tool for HD patients as well as it provides them with an immediate and easy connection to their peers. In addition to the existing applications that Google Glass provides, including hands-free calling, texting and taking photos, the Newcastle research team has also developed software to help patients with Parkinson’s disease by providing discrete prompts that remind users to speak loudly or to swallow in order to prevent them from drooling, a common side effect for both Parkinson’s and HD. Because both HD and Parkinson’s disease patients often have difficulty moving from one point to another, the research team uses a visual cue such as a laser pen pointer to prompt the patients to start moving again. The motion sensing technology and heads up display of Google Glass have potential to make the process more intuitive.

The initial findings from the Newcastle study will shortly be presented at the ACM Human Factors in Computing Systems (CHI) 2014 conference in Toronto, Canada, which runs from April 26 to May 1. To watch the video on the Newcastle’s study on using Google Glass to help people with Parkinson’s, click HERE.

Although the researchers are aiming to use Google Glass to help patients with Parkinson’s disease, its application to help HD patients could be endless.

N. Jumreornvong 2014

HOPES is a team of faculty and undergraduate students at Stanford University dedicated to making scientific information about Huntington’s disease (HD) more readily accessible to the public